Pregnancy Induced Hypertension (PIH)?is?an increase in blood pressure after?20 weeks of gestation and?occurs in about?5 to 7% of?pregnant women. ?In PIH, vasospams of?both the?small and large arteries occur resulting in various manifestations.?The cause of PIH is unknown but there are various risk factors that are associated with it;
Pregnancy Induced Hypertension Risk Factors
Multiple pregnancies
Race (more common in women of color).
Pregnant women who are younger than 20 years or older than 40 years.
Women who have given birth more than five times.
Pregnant women coming from low economic status?background.
Women with medical history of other conditions. Such as kidney or heart problems.
Women with?history of hypertension (essential hypertension).
Women who have less than normal amniotic fluid (hydramnios).
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Symptoms of Pregnancy Induced Hypertension
The symptoms and signs experienced by?a woman?depends on the stage of?progression. Pregnancy Induced Hypertension is classified into different categories;
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Gestational Hypertension
Mild Preeclampsia
Severe Preeclampsia
Eclampsia
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Gestational Hypertension
A woman is said to be having a gestational hypertension when?the blood pressure is 140/90mmHg without presence of protein in urine or edema (swelling).? In most cases, no medical treatment is ordered for?such cases since it is usually very mild and can be managed with other means.
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Mild Preeclampsia
A woman is said to be having a Mild Preeclampsia if the blood pressure is above 140/90mmHg taken atleast in two occassion with 6 hours in between takings. Another way to?assess is by looking at?the woman's?previous?blood presssure readings. An?increase in diastolic pressure of more than 30mmHg and diastolic pressure greater than 15mmHg from the base line readings, suggests a woman is?developing a?Preeclampsia.
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In normal pregnancy, most women shows a?trace of protein in urine samples. In?Mild Preeclampsia, apart?from the high blood pressure readings, there is?presence of?1+ or 2+ protein in urine. Edema also?develop due to protein loss and sodium retention. Woman may start to gain weight due to?edema,?mostly pronounced?on?the upper part of the body.
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A significant weight gain of more than 2 pounds in a week in the second trimester or more than 1 pound in a week in the third trimester may be another sign that woman is having?Preeclampsia.
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Severe Preeclampsia
A woman is considered to have developed a Severe Preeclampsia when the blood pressure increases?up to?160/110mmHg or above, taken at least two times with 6 hours in between the takings when the woman is at bed rest.
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In Severe Preeclampsia, there is presence of 3+ or 4+ protein in urine taken randomly or more than 5g in a 24 hours urine sample. Women present with puffy face and hands due to extensive edema. Other signs of Severe Preeclampsia include;
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Decreased urine flow (urinating less than 500ml or less in 24 hours).
Abnormal renal function tests - increased creatinine of more than 1.2 mg/dl.
Headache
Blurred vision
Noticeable edema on the peripherals - woman may experience shortness of breath if pulmonary edema is presence.
Liver dsfunction
Epigastric pain
Nausea and vomitting may occur
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Eclampsia
This is the most fatal?classification of pregnancy induced hypertension.? A woman having eclampsia?experience all other symptoms of PIH plus seizure or coma.??This is because at this stage, the?cerebral edema is so intensive causing?cerebral hemorrhage, renal failure or circulatory collapse and eventually may lead to?death. Maternal?and fetal mortality rate with Eclampsia is as high as 20 and 25%?, respectively.
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Pregnancy Induced Hypertension Treatment
Treatment of Pregnancy Induced Hypertension depends on the stage of advancement. Gestational hypertension and Mild Preeclampsia may not require any medication and can be managed easily at home with proper follow ups.
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On the other hand, women with Severe Preeclampsia requires?hospitalization for close monitoring. If the fetus is already passed 36 weeks and the lung is mature, pregnancy can be terminated. If not, woman is put under medication?and frequent monitoring is maintained.
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In Severe Preeclampsia,?hypotensive drugs such as hydralazine may be prescribed for hypertension and for women under Eclampsia watch, magnesium sulfate is the drug of choice which is?administered to prevent eclampsia.
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Other non-pharmacology management of pregnancy induced hypertension?are;
Encouraging?woman to take?bed rest.
Providing proper nutrition to the woman.
The woman room is maintained dark since bright light can trigger a seizure.
Providing emotional or psychological support to the woman.
Frequent monitoring of the mother and the fetus.
Source: http://healthfitnessconditions.blogspot.com/2012/12/high-blood-pressure-when-pregnant.html
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